Treatment strategies for Parkinson’s disease

Abstract

Abstract:Parkinson's disease (PD) is caused by progressive degeneration of dopamine (DA) neurons in the substantia nigra pars compacta (SNpc), resulting in the deficiency of DA in the striatum. Thus, symptoms are developed, such as akinesia, rigidity and tremor. The aetiology of neuronal death in PD still remains unclear. Several possible mechanisms of the degeneration of dopaminergic neurons are still elusive. Various mechanisms of neuronal degeneration in PD have been proposed, including formation of free radicals, oxidative stress, mitochondrial dysfunction, excitotoxicity, calcium cytotoxicity, trophic factor deficiency, inflammatory processes, genetic factors, environmental factors, toxic action of nitric oxide, and apoptosis.All these factors interact with each other, inducing a vicious cycle of toxicity causing neuronal dysfunction, atrophy and finally cell death. Considerable evidence suggests that free radicals and oxidative stress may play key roles in the pathogenesis of PD. However, currently, drug therapy cannot completely cure the disease. DA replacement therapy with levodopa (LDopa), although still being a gold standard for symptomatic treatment of PD, only alleviates the clinical symptoms. Furthermore, patients usually experience severe side effects several years after the L-Dopa treatment. Until now, no therapy is available to stop or at least slow down the neurodegeneration in patients. Therefore, efforts are made not only to improve the effect of LDopa treatment for PD, but also to investigate new drugs with both antiparkinsonian and neuroprotective effects. Here, the advantages and limitations of current and future therapies for PD were dicussed. Current therapies include dopaminergic therapy, DA agonists, MAO-B inhibitor, COMT inhibitors, anticholinergic drugs, surgical procedures such as pallidotomy and more specifically deep brain stimulation of the globus pallidus pars interna (GPi) or subthalamic nucleus (STN), and stem cell transplantation.

Recent trends in the development of nanophytobioactive compounds and delivery systems for their possible role in reducing oxidative stress in Parkinson’s disease models

“…3,36,[40][41][42][43] Extensive animal model studies have been conducted about the sustained protective role of different synthetic and natural bioactive compounds against dopaminergic neuron loss in PD. [44][45][46][47][48][49] Based on limitations for using synthetic compounds, [50][51][52] natural phytobioactive compounds play an important role in preventing PD. 38,48 Phytobioactive compounds from various medicinal plants show neuroprotective effects in various animal models.…”

Progressive loss of striatal dopamine terminals in MPTP-induced acute parkinsonism in cynomolgus monkeys using vesicular monoamine transporter type 2 PET imaging ([18F]AV-133)

“…The cardinal clinical symptoms are bradykinesia, tremor, rigidity, and postural instability with the pathological characteristic of evolutional nigrostriatal dopaminergic neurodegeneration [2,3] . 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is a neurotoxin that induces parkinsonism in both humans [4] and non-human primates [5] with the cognitive, biochemical, histological and classical behavioral changes that occur in PD [6] .…”

A Review on Traditional Herbs Used in Parkinson’s Disease (Nadukku Vatham)

“…The plant has also been found to increase the generalized neurological and cognitive function and is a mood enhancer. [18] Many studies have proved that the plant possess antioxidant, antiamnesic [19] , anxiolytic [20] , antistress and antiulcerogenic [21] efficacy.…”